Procurement Processes at Gwanda Provincial Hospital, Matebeleland South Province, Zimbabwe, 2012; a Descriptive Cross Sectional Study

Introduction: Gwanda Provincial Hospital received one million eight hundred dollars from treasury in 2011 through Targeted Approach. By year end, the hospital experienced stock-outs of essential goods, medicines and surgicals. A routine audit carried out in 2012 exposed procurement irregularities. We conducted this study to evaluate adherence to procurement and accountability by public health officials in the institution. Methods: We conducted a descriptive cross sectional study at Gwanda Hospital. We used interviewer administered questionnaires, key informant interviews and desk review of records for data collection. Results: Fifty seven primary respondents were interviewed and we reviewed 47 procurement documents. The majority were nurses (29.8%), 53% were females. The median age in service was 10.5 years (Q1=4; Q3=17). Fiftyeight percent had low knowledge on procurement processes. Legislation and policy documents on procurement were not easily accessible. Key procurement committees were non functional while inter-departmental communication was poor. Procured goods were reported to be of poor quality. Conclusion: The hospital did not getting value for money during Target Approach. Administrative controls on procurement processes were not followed. There was no proper procurement planning. Procurement trends were not being utilized to inform decision making. As a result of this study, staff trainings on procurement were conducted while standard operating procedures on procurement were developed. This study is the first published document on understanding procurement processes in Zimbabwe public health delivery at a tertiary referral institution. The study will add to existing knowledge on improving accountability of public health managers in resource poor settings.